Servicio de Urología, Hospital Universitario Sanitas La Moraleja, Madrid, España.
Servicio de Urología, Hospital Clínico San Carlos, Madrid, España.
Actas Urol Esp (Engl Ed). 2020 May;44(4):233-238. doi: 10.1016/j.acuro.2019.11.002. Epub 2020 Mar 6.
To study the influence of clean intermittent catheterization (CIC) on the lower urinary tract function in patients with urinary retention (UR) due to detrusor underactivity (DU).
A longitudinal study was carried out on 49 patients (28 men, 21 women) of mean age 55years, who underwent CIC for UR secondary to DU. The mean CIC frequency was 3.15 times/day. Patients' clinical data were collected, and they underwent urodynamic study before and after CIC, with a mean interval of 4years. Fisher's exact test was used for the analysis of categorical variables and Student's t test for parametric variables. The level of significance was set at 0.05 for a two-tailed test.
The second urodynamic study showed a significantly increased bladder compliance, the Bladder Outlet Obstruction Index (BOOI) and the Bladder Contractility Index (BCI) also increased but without reaching statistical significance. There was a significantly higher percentage of benign prostatic hyperplasia (BPH) and acontractile detrusor cases among the group of patients whose BCI improved after CIC, with significantly lower CIC time.
CIC improved bladder compliance in the patients of our series. The BCI improved in BPH patients and in patients with acontractile detrusor.
研究清洁间歇性导尿(CIC)对因逼尿肌无力(DU)导致尿潴留(UR)患者下尿路功能的影响。
对 49 例(男 28 例,女 21 例)年龄 55 岁的患者进行了纵向研究,这些患者因 DU 继发 UR 而行 CIC。平均 CIC 频率为 3.15 次/天。收集患者的临床资料,在 CIC 前后进行尿动力学研究,平均间隔 4 年。采用 Fisher 确切检验分析分类变量,采用 Student t 检验分析参数变量。双侧检验的显著性水平设定为 0.05。
第二次尿动力学研究显示膀胱顺应性显著增加,膀胱出口梗阻指数(BOOI)和膀胱收缩力指数(BCI)也增加,但无统计学意义。在 CIC 后 BCI 改善的患者中,良性前列腺增生(BPH)和无收缩性逼尿肌的比例明显更高,CIC 时间明显更短。
在我们的研究中,CIC 改善了膀胱顺应性。BCI 在 BPH 患者和无收缩性逼尿肌患者中得到改善。